Risk Factor for PD Catheter Failure Identified
A study of risk factors associated with peritoneal dialysis (PD) catheter survival found that a non-infectious catheter-related problem was the only independent variable significantly associated with an increased risk of catheter failure.
The nine-year single-center study, led by Ramesh Saxena, MD, PhD, of the University of Texas Southwestern Medical Center in Dallas, included 315 PD patients who had their first PD catheters placed. Overall PD catheter survival rates over 12, 24, and 36 months were 92.9%, 91.9%, and 91.1%, respectively. Of the 315 patients, 76 experienced 87 episodes of non-infectious PD catheter-related complications, which included such problems as malpositioning/tip migration, obstruction, catheter leaks, catheter extrusion, hole in the external catheter, hematoma around the exit-site, chronic abdominal pain, trauma and other undocumented reasons.
Compared with patients who did not have a non-infectious PD catheter-related problem, those who did had a 22 times increased risk of catheter failure, researchers reported online in the Journal of Vascular Access.
Gender, race, age, body mass index, diabetes status, comorbidities, previous abdominal surgeries, peritoneal infections, or exit site/tunnel infections had no significant effect on PD catheter survival. Consequently, the authors concluded that these factors should not be considered barriers in selecting patients for PD.
More than 90% of patients had at least one or more comorbidities and 57.5% had history of previous abdominal surgery. The patients had a mean age of 49.7 years; 54.6% of subjects were women and 42.5% were African Americans. Diabetes was the primary etiology of end-stage renal disease in 43.2% of patients.